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Anesthesia and the Endocrine System

Total questions: 10

Worksheet time: 26mins

Name
Class
Date
1.

Which of the following patients would not be hyperthyroid?

a)

A patient with elevated T4 and elevated thyroxine-binding globulin levels

b)

A patient with elevated T3 and T4

c)

A patient with elevated T4 and normal T3

d)

A patient with elevated T4 and low thyroxine-binding globulin

e)

A patient with normal thyroxine-binding globulin and elevated T3

2.

Which of the following statements regarding Type I diabetes mellitus is true?

a)

Patients usually have normal insulin levels and significant insulin resistance in peripheral tissues.

b)

Patients often are treated with diet alone.

c)

Patients frequently are obese.

d)

Patients are prone to ketoacidosis.

e)

End-organ damage is rare.

3.

Which of the following will increase ionized serum calcium?

a)

Elevated serum albumin

b)

Alkalosis

c)

Acute hypomagnesemia

d)

Hypoparathyroidism

e)

Acute hyperphosphatemia

4.

Which of the following statements regarding pheochromocytoma is true?

a)

It is a common adrenal cortical malignancy.

b)

Pheochromocytoma rumors are not directly innervated, and catecholamine release is random.

c)

It is a common cause of primary hypertension.

d)

Cardiovascular effects from pheochromocytoma are treated easily with deep anesthesia.

e)

It is diagnosed easily and reliably by measurement of free catecholamines in the urine.

5.

Which statement regarding Cushing’s syndrome is false?

a)

Most cases occur secondary to bilateral adrenal hyperplasia.

b)

Cushing’s syndrome usually represents adrenal adenocarcinoma when it occurs in older patients.

c)

Twenty-five percent of cases are caused by adrenal neoplasm.

d)

It may occur iatrogenically from steroid treatment of chronic illness.

e)

It may be caused by an underproduction of cortisol by the adrenal cortex.

6.

True of hypoglycemia in the patient undergoing general anesthesia, except:

a)

Is diagnosed easily by recognition of the usual signs and symptoms

b)

Causes effects that are misinterpreted as light anesthesia

c)

Often occurs inadvertently in diabetic patients who receive insulin perioperatively

d)

Occurs more commonly in diabetic patients with renal insufficiency

e)

Reflex catecholamine release causes tachycardia, hypertension and diaphoresis

7.

Which of the following statements with respect to patients with Addison’s disease is false?

a)

The predominant cause of Addison’s disease is autoimmune destruction of the adrenal gland

b)

Patients with secondary forms of Addison’s disease are always hyperpigmented

c)

Treatment includes replacement of mineralocorticoids

d)

Diagnosis is confirmed by failure of adrenal gland to respond to exogenously administered ACTH.

e)

Treatment involves replacement of glucocorticoids

8.

Which of the following statements regarding the posterior pituitary are true, except:

a)

It is composed of terminal nerve endings that extend from the ventral hypothalamus

b)

It secretes vasopressin

c)

It secretes antidiuretic hormone (ADH)

d)

It secretes oxytocin

e)

Acromegaly as consequence of excess growth hormone excreted in this region

9.

Which of the following statements regarding diabetes insipidus is true, except:

a)

It can occur following intracranial trauma

b)

Urine output is highly concentrated

c)

Symptoms include polydipsia

d)

There is inadequate secretion of ADH

e)

Can be caused by destruction of the pituitary gland by lesions or surgery

10.

Patients with mild to moderate hypothyroidism

a)

Are at significant risk for perioperative congestive heart failure

b)

Are at significant risk for postoperative ventilatory support

c)

Can be anesthetized safely without preoperative thyroid supplementation

d)

Are very sensitive to the effects of anesthetic drugs

e)

Should have urgent thyroid replacement before surgery if there is history of coronary artery disease